What Does a Medical Coder Do?
Medical coders transcribe patients’ records into universal medical codes that allow them to process claims for reimbursement from providers in accordance with policies. A medical coder should know a wide range of codes, including Current Procedural Terminology (CPT), the Healthcare Common Procedure Coding System (HCPCS), and the International Classification of Diseases Tenth Revision Clinical Modification (ICD-10 CM). They must use their own judgment and attention to detail to ensure the codes are assigned correctly according to government and insurance regulations.
Medical coders need a keen eye for detail and good analytical skills. Proficiency with computers and coding software are also required. Furthermore, they need exceptional verbal and written communication skills and must be extremely well organized. It is important that medical coders use discretion and maintains confidentiality as they handle sensitive patient information. Medical coders work at hospitals, clinics, and doctor’s offices but can sometimes also work directly for insurance companies as well.
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National Average Salary
Medical coder salaries vary by experience, industry, organization size, and geography. To explore salary ranges by local market, please visit our sister site zengig.com.
The average U.S. salary for a Medical Coder is:
Medical Coder Job Descriptions
Under the direction of the Coding Manager, functions as a coder for the Health Information Management Department to collect and classify diagnostic, procedural, and patient information from physicians and medical records. This position has the option to work remotely.
Education, qualifications, and standards
- Certified Coding Specialist (CCS) with at least one year of acute care coding experience
- OR a Registered Health Information Administrator (RHIA) with at least one year of acute care coding experience
- OR a Registered Health Information Technician (RHIT) with at least one year of acute care coding experience
- OR a Certified Coding Associate (CCA) with at least two years of acute care coding experience
- OR a Certified Professional Coder/Hospital (CPCH) with at least two years of acute care coding experience
- OR a Bachelor’s Degree with at least one year of acute care coding experience
- OR an Associate Degree with at least one year of acute care coding experience
- OR a High School Diploma with at least three years of acute care coding experience
- AND must score 80% or higher on the HIM Coding Screening competency.ICD-10, CPT-4, Medical Spelling, and Med Term Prefixes
Job summary and qualifications
As a Medical Coder, you will contribute to the company’s mission and vision by reviewing medical record documentation. You will apply appropriate coding based on the diagnosis and procedure guidelines for code selections that adhere to the company’s Coding Compliance Policies and Procedures.
- You will code outpatient surgery center(s) records in a timely manner, including the assignment of ICD-10-CM, E/M, Procedure Categories, and HCPCS/CPT procedure codes
- You will code an average of 80-150 charts per day
- You are responsible for resolving codes and diagnoses with conflicting or unclear information by utilizing the query tool to gather additional information
- You will ensure 3M encoder updates are timely and accurate
- You will bill cases by furnishing completed assessments of billing supplies and implants
- You will be assisting with the preparation for accrediting bodies and/or state reviews
- You are responsible for reviewing official data quality standards, coding guidelines, company policies, and procedures, and clinical resources to assure coding knowledge and skills remain current
- A registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) college degree preferred
- Minimum (2) years experience in outpatient coding and/or Health Information Management required
- Minimum (1) year of experience in a medical office setting highly preferred (i.e. ambulatory surgery center, hospital, doctor’s office)
- Completed coursework in Human Anatomy & Physiology, Medical Terminology, and Introduction to Coding (including ICD-10 and CPT) preferred
- Successful completion of an ICD-10-CM training or certification curriculum; or if currently pursuing such, then completion of 50% or more of the curriculum to date with an expectation of finishing within 2 months after hire
- Must provide certification from a recognized professional coding organization, transcript from an educational institution, or similar proof of successful completion (i.e., competency assessments)
A healthcare network in (City) is looking to add a new Medical Coder for a promising opportunity with their team in (City). In this role, the Medical Coder will be responsible for supporting medical professional corporations’ procedural and diagnostic coding of medical records for billing.
- Works with professional and non-professional staff for timely record review and ensuring the accuracy of medical documentation and sequencing ensuring that codes meet required legal and insurance rules
- Works with internal and external billing staff to ensure timely and complete billing of claims and encounters
- Collaborates and corresponds with insurance companies and healthcare professionals to resolve claim denials
- Maintains medical records both electronically and hard copies and maintains productivity and chart metrics
- Collaborates with management staff for process improvement, project work, etc.
- Performs compliance audits regarding billing, procedural and diagnostic coding to ensure documentation is accurate and timely
- Submits statistical data for analysis and research by other departments
- Performs other duties, as needed
- 1+ years of Medical Record Coding & Record Review experience
- Associate’s Degree
- Certified as Professional Coder (CPC or CSS-P)
- ICD-10 certified, knowledge and experience in CPT codes required
- Proficiency with Electronic Medical Records (EMR) or Electronic Health Records (EHR) required
- Medical terminology and coding both ICD-9 and ICD-10, CPT
- Experience in Internal and External Audits
- Knowledge of the Billing Cycle
- Microsoft Office Suite proficient
- Solid problem-solving and time-management skills
- Great interpersonal skills
- Excellent communication skills (written and verbal)
- Strong attention to detail
- Highly organized
- Bachelor’s Degree
- Certified Risk Adjustment Coder (CRC)
- Experience working within a Managed Care Health Organization and Outpatient Medical practice
How to Hire a Medical Coder
When hiring a medical coder, first consider the following:
- Recruiting: Do you have the knowledge, tools, and resources to attract and screen candidates?
- Complexity: Do you need a senior professional, or will mid or junior-level skills and experience suffice?
- Duration: Is this a one-time project or an ongoing need?
- Management: Do you have the time and expertise to direct the work effectively?
- Urgency: How soon does the work need to be completed?
- Headcount: Do you have the budget and approval for an internal employee, or should you consider alternate options?
Answering these questions will help determine the best course of action for your current hiring need. Fortunately, great options exist for every scenario. These are our recommendations:
1. Use 4 Corner Resources (or another professional recruiting firm)
The heavy lifting is done for you when working with a top-tier staffing company like 4 Corner Resources. We source, screen, recruit, and deliver only the most qualified candidate(s), saving you significant time and effort throughout the hiring process while you remain focused on your core business. Understanding your needs and ensuring the right candidate for the position is the key to our success.
This is the best route to take when:
- You need to fill the position quickly
- You want access to a vast talent pool of high-quality, prescreened candidates
- Your position is suited for temporary hiring services, contract staffing, or contract-to-hire recruiting, and you intend to direct the work activity.
- You are hiring an employee as a direct placement but aren’t able to recruit effectively or efficiently with your internal staff.
- You aren’t familiar with current salary rates, market trends, and available skill sets
2. Advertise your opening on a top job board
Your best option may be to advertise your opening on a proven job board. There are many widely used job sites out there that draw visits from qualified candidates. If you have someone internally who can dedicate the time and energy to sort through applications and screen individuals effectively, this can be a great choice.
We recommend using a job board when:
- Your internal recruiting team has the knowledge and experience to assess candidate qualifications
- You are hiring a direct employee and have time to manage the entire recruiting effort
- You have a process for receiving, screening, and tracking all resumes and applications
- You are prepared to respond to all applicants
There are many career sites out there. Here are the two we recommend for a medical coder opening:
CareerBuilder has been a trusted source for hiring since 1995. Reach 80+ million unique, diverse U.S. job seekers annually by posting your jobs through their talent acquisition channels. Through CareerBuilder, you can engage candidates and drive them into your sourcing pipeline. We recommend using CareerBuilder for hiring when you have the internal resources and processes to review, screen, and reply to all applicants.
LinkedIn is a social network for job seekers, professionals, and businesses. With this popular job site, you can enhance your brand and advertise your open position to a wide audience of motivated, qualified candidates. Job postings on LinkedIn are also extremely streamlined and user-friendly, making it even easier for candidates to apply. Additionally, applicants can use their LinkedIn profile instead of a resume to expedite the process.
3. Leverage your internal resources
You can utilize your own website, social media, and employees to assist in your search for top candidates.
A company website posting should be the first step in notifying prospective candidates that you are hiring. Social media can also be a powerful tool for spreading the word about your new opening. As far as exposure is concerned, this option can be as good as some job boards when you have a large enough following across various platforms, like LinkedIn, Instagram, Facebook, TikTok, and Twitter.
Current employees are every organization’s greatest asset. Encourage your internal team to promote job openings to their network by offering cash and other incentives.
We recommend these options when:
- Your brand has great name recognition
- You can consistently monitor and respond to candidate activity through your website and social media accounts
- You have a process in place to quickly and broadly communicate job openings and requirements
- You have an effective employee referral program in place
If you aren’t sure which path is best, schedule a discovery call today with our seasoned recruiting professionals. The 4 Corner team is on standby to help you find the best option for your unique hiring need.
Sample Interview Questions
- When assigning medical codes, how do you ensure accuracy and completeness?
- What is your experience with medical coding software and electronic submission of claims?
- Is there a way to stay informed about changes in medical coding regulations?
- Could you please explain how to review medical records and choose appropriate codes?
- What steps do you take to resolve discrepancies or inconsistencies in medical records?
- Have you ever had to discuss coding issues with a physician or another healthcare professional?
- What do you do to manage your workload and prioritize tasks so that you can submit your claims and codes on time?
- When have you had to collaborate with other healthcare professionals, such as nurses or medical billers, to solve a coding issue?
- What are your procedures for maintaining accurate and up-to-date coding records and ensuring patient confidentiality and security?